Intestinal Ulcers

Overview

Intestinal ulcers also are known as inflammatory bowel disease compromises of 2 major disorders (ulcerative colitis and Crohn's disease). They have distinct pathological and clinical entities but more often overlap. Extraintestinal manifestations develop in 25-40% of patients with both ulcerative colitis and Crohn's disease.

Signs and Symptoms

Variable- relapsing and remitting course, Intermittent attacks of diarrhea/ abdominal pain and fever, Attacks precipitated by emotional stress, Occult or overt faecal blood loss leading to anaemia, Malabsorption of B1 leading to megaloblastic anaemia, Weight loss, Arthritis (migratory polyarthritis/ sacroiliitis/ ankylosing spondylitis), Uveitis, Erythema nodosum, Clubbing of fingertips

Common Causes

Genetic: There is significant evidence for a genetic basis to IBD since certain populations have an increased incidence of the disease. Furthermore, disease prevalence is increased in first-degree relatives of IBD patients (5%–10%), Smoking: Ulcerative colitis is inversely correlated to cigarette smoking; in contrast, Crohn's disease is directly related to smoking, Intake of certain drugs or types of food, e.g. simple sugars, have also been thought to precipitate episodes of Crohn's disease, Infectious agents could also be a causative factor in IBD. Both mycobacteria and organisms forming part of the normal gut flora have been suspected of having a pathogenic role in IBD, Abnormalities of the immune system, including autoimmunity, the formation of immune complexes and disorders of cell-mediated immunity, have been proposed to explain the pathogenesis of IBD, Psychological factor: Major psychological stressors, such as loss of a close relative, have been linked to IBD attacks, and it has been proposed that IBD sufferers have a characteristic personality type which is particularly susceptible to emotional stress.

Investigation Techniques

Full blood count for anemia or infection, Fecal occult blood test, Colonoscopy, Flexible sigmoidoscopy exam, Upper endoscopy, Capsule endoscopy, Balloon-assisted enteroscopy, X-ray, Computerized tomography (CT) scan, Magnetic resonance imaging (MRI)

Treatment and Prevention

5-ASA-containing compounds (Mesalazine/ Pentasa/ Asacolon/ Salofalk/ Sulphasalazine/ Salazopyrin/ Olsalazine/ Dipentum), Corticosteroids (Hydrocortisone/ Prednisolone/ Rectal preparations Colifoam and Predsol/ Budesonide), Steroid sparing agents, Antibiotics (metronidazole/ Flagyl), Nutritional therapy, Biological therapy, Immunosuppressives (Azathioprine/ 6-Mercaptopurine/ Infliximab), Surgery